Published: 2021-09-27

Clinical characterisation and management outcomes of COVID-19 infection in pregnancy in a Nigerian tertiary hospital

Omotade A. Ijarotimi, Akaninyene E. Ubom, Ibraheem O. Awowole, Ekundayo O. Ayegbusi, Oluwafemi Kuti


Background: Literature on the antenatal and perinatal management and outcomes of COVID-19 infection in pregnancy in Nigeria and sub-Saharan Africa is gradually emerging but sparse. There is an urgent need to build up the knowledge base of COVID-19 infection in Nigerian pregnant women. The objective of the current study was to determine the clinical characteristics and management outcomes of COVID-19 infection in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.

Methods: A one-year retrospective review of all cases of COVID-19 infection in pregnancy managed at the OAUTHC. Relevant data were extracted from the case records of all cases managed using a purpose-designed proforma. Data collected was analysed using IBM-SPSS, version 24. Associations between categorical variables were assessed using chi square, with level of significance set at <0.05.

Results: A total of 22 cases were managed. Majority (15, 68.2%) of the women were either asymptomatic or had mild symptoms. The commonest symptom was cough (8, 36.4%). The mean duration of admission was 6.6±4.2 days. The most common maternal and perinatal complication was preterm delivery/birth (3, 13.6%). There was no maternal mortality. The mean birth weight of the babies was 3226g±597g, with mean 1- and 5- minutes Apgar scores of 8.0±1.3 and 9.5±0.6 respectively.

Conclusions: Although COVID-19 infection in pregnancy is an asymptomatic or mild infection in the majority of cases in Ile-Ife, Nigeria, it is associated with adverse maternal and perinatal outcomes. Further studies are recommended to determine transplacental transmission of COVID-19 infection and antibodies.


COVID-19, SARS-CoV-2, Pregnancy, Maternal and perinatal outcomes, Nigeria

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Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020;27(2):20.

Ohia C, Bakarey AS, Ahmad T. COVID-19 and Nigeria: Putting the realities in context. Int J Infect Dis. 2020;95:279-81.

Outbreak Brief 75: Coronavirus Disease 2019 (COVID-19) Pandemic. Available at: www.africacdc. org. 22 June 2021. Accessed on 30 June 2021.

COVID-19 Nigeria. Available at: www.covid19.ncdc. Accessed on 30 June 2021.

Chen L, Li Q, Zheng D. Clinical characteristics of pregnant women with Covid-19 in Wuhan, China. N Engl J Med. 2020;382:e100.

Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020; 99:823-9.

Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020;45:52-9.

Makwe CC, Okunade KS, Rotimi MK, Ekor OE, Oyeleke OG, Bello QO, et al. Caesarean delivery of first prediagnosed COVID-19 pregnancy in Nigeria. Pan Afr Med J. 2020;36:100.

Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis. 2020;20(5):559-64.

Parazzini F, Bortolus R, Mauri PA, Favilli A, Gerli S, Ferrazzi E. Delivery in pregnant women infected with SARS-CoV-2: a fast review. Int J Gynaecol Obstet. 2020;150(1):41-6.

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15.

Osaikhuwuomwan J, Ezeanochie M, Uwagboe C, Ndukwu K, Yusuf S, Ande A. Clinical characteristics and outcomes for pregnant women diagnosed with COVID-19 disease at the University of Benin Teaching Hospital, Benin City, Nigeria. Pan African Med J. 2021;39:134.

Childbirth, breastfeeding, and COVID-19. Available at: Accessed on 30 June 2021.

Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Available at: https://www.covid19 Accessed on 30 June 2021.

Gajbhiye RK, Modi DN, Mahale SD. Pregnancy outcomes, newborn complications, and maternal-fetal transmission of SRAS-CoV-2 in women with COVID-19: a systematic review of 441 cases. MedRxiv. 2020;2020:e45215732.

Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with coronavirus disease 2019 (COVID-19) pneumonia: a case-control study. Clin Infect Dis. 2020;71(16):2035-41.

Ijarotimi OA, Ubom AE, Olofinbiyi BA, Kuye-Kuku T, Orji EO, Ikimalo JI. COVID-19 and obstetric practice: A critical review of the Nigerian situation. Int J Gynaecol Obstet. 2020;151(1):17-22.

Rajewska A, Mikolajek-Bedner W, Lebdowicz-Knul J, Sokolowska M, Kwiatkowski S, Torbé A. COVID-19 and pregnancy- where are we now? A review. J Perinat Med. 2020;48(5):428-34.

Pullen MF, Skipper CP, Hullsiek KH, Bangdiwala AS, Pastick KA, Okafor EC et al. Symptoms of COVID-19 outpatients in the United States. Infect Dis. 2020;7(7):271.

Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P et al. Comorbidity and its impact on patients with COVID-19. SN Compr Clin Med. 2020:1-8.

Paudel SS. A meta-analysis of 2019 novel coronavirus patient clinical characteristics and comorbidities. Clin Infect Dis. 2020;70(14):1524-7.

W-Jie G, Liang W-H, He J-X, Zhong N-S. Cardiovascular comorbidity and its impact on patients with COVID-19. Eur Respir J. 2020;55:2001227.

Sieswerda E, De Boer MG, Bonten MM, Boersma WG, Jonkers RE, Aleva RM, et al. Recommendations for antibacterial therapy in adults with COVID-19- an evidence based guideline. Clin Microbiol Infect. 2021;27(1):61-6.

Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020; 9:51-60.

Cai J, Tang M, Gao Y, Zhang H, Yang Y, Zhang D, et al. Cesarean section or vaginal delivery to prevent possible vertical transmission from a pregnant mother confirmed with COVID-19 to a neonate: a systematic review. Front Med. 2021;8:109.